Healthcare Provider Details

I. General information

NPI: 1619988284
Provider Name (Legal Business Name): BRIGHT MEDICAL TECHNOLOGY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 09/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 2040 NAPFLE ST
PHILADELPHIA PA
19152
US

IV. Provider business mailing address

2020 2040 NAPFLE ST
PHILADELPHIA PA
19152
US

V. Phone/Fax

Practice location:
  • Phone: 215-725-6337
  • Fax: 215-725-7630
Mailing address:
  • Phone: 215-942-7963
  • Fax: 215-942-0438

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPP481246
License Number StatePA

VIII. Authorized Official

Name: JENNIFER GOLDSMAN
Title or Position: OWNER
Credential:
Phone: 215-942-7963